<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
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    <body>

       
        <form id="contactform" method="post" action="">

            <label for="nome">Nome:</label>
            <input type="text" class="input" name="nome" id="nome" required maxlength="72" size="72"/>         

            <label for="codnome">Apelido:</label>
            <input type="text" class="input" name="codnome" id="codnome" maxlength="40" size="40"/>

            <label for="endereco">Endereço:</label>
            <input type="text" class="input" name="endereco" id="endereco" required maxlength="72" size="72"/>                

            <label for="numero">Nº</label>
            <input type="text" class="input" name="numero" id="numero"/>                

            <label for="complemento">Complemento:</label>
            <input type="text" class="input" name="complemento" id="complemento" maxlength="40" size="40"/>                

            <label for="bairro">Bairro:</label>
            <input type="text" class="input" name="bairro" id="bairro" required maxlength="60" size="60" />

            <label for="cidade">Cidade:</label>
            <input type="text" class="input" name="cidade" id="cidade" required maxlength="60" size="60" />

            <label for="cep">Cep:</label>
            <input type="text" class="input" name="cep" id="cep" required maxlength="10" size="10"/> <br/>

            <label for="uf">
                UF:
            </label>
                <select name="estados" id="estado" style="width:160px;" required >
                    <option value="">Selecione Estado</option>
                    <option value="1">AC</option>
                    <option value="2">AL</option>
                    <option value="3">AM</option>
                    <option value="4">AP</option>
                    <option value="5">BA</option>
                    <option value="6">CE</option>
                    <option value="7">DF</option>
                    <option value="8">ES</option>
                    <option value="9">GO</option>
                    <option value="10">MA</option>
                    <option value="11">MG</option>
                    <option value="12">MS</option>
                    <option value="13">MT</option>
                    <option value="14">PA</option>
                    <option value="15">PB</option>
                    <option value="16">PE</option>
                    <option value="17">PI</option>
                    <option value="18">PR</option>
                    <option value="19">RJ</option>
                    <option value="20">RN</option>
                    <option value="21">RO</option>
                    <option value="22">RR</option>
                    <option value="23">RS</option>
                    <option value="24">SC</option>
                    <option value="25">SE</option>
                    <option value="26">SP</option>
                    <option value="27">TO</option>
                </select>
            
            <br/>
            <br/>
            <input type="submit" name="submit"  class="button" value="Gravar" />

        </form>
    </body>
</html>
